2016
DOI: 10.1155/2016/1095927
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Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification

Abstract: We present a case of a 47-year-old male who suffered from GE around his lower anterior teeth as soon as he started treatment with Felodipine 400 mg. We show that oral hygiene measures, antibiotics, and conventional periodontal treatment (scaling and root planing SRP) were all not sufficient to resolve the drug induced GE, which will persist and/or recur provided that systemic effect of the offending medication is still present. The condition immediately resolved after switching to a different medication. The m… Show more

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Cited by 4 publications
(4 citation statements)
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“…The three medications that the patient is on are linked with dry mouth. Khzam et al described a similar case of generalized gingival enlargement linked with Felodipine; an antihypertensive medication with a known adverse effect of xerostomia revealed exact same diagnosis (ulcerative fibrous epulis with osseous metaplasia) 25 . The medication‐induced xerostomia could have been a contributing risk factor to the development of the fibrous epulis since dry oral mucosa is more susceptible to damage from local irritants (hormonal imbalance and localized periodontitis in this case) when compared to a moist and hydrated surface.…”
Section: Discussionmentioning
confidence: 79%
See 1 more Smart Citation
“…The three medications that the patient is on are linked with dry mouth. Khzam et al described a similar case of generalized gingival enlargement linked with Felodipine; an antihypertensive medication with a known adverse effect of xerostomia revealed exact same diagnosis (ulcerative fibrous epulis with osseous metaplasia) 25 . The medication‐induced xerostomia could have been a contributing risk factor to the development of the fibrous epulis since dry oral mucosa is more susceptible to damage from local irritants (hormonal imbalance and localized periodontitis in this case) when compared to a moist and hydrated surface.…”
Section: Discussionmentioning
confidence: 79%
“…Khzam et al described a similar case of generalized gingival enlargement linked with Felodipine; an antihypertensive medication with a known adverse effect of xerostomia revealed exact same diagnosis (ulcerative fibrous epulis with osseous metaplasia). 25 The medication-induced xerostomia could have been a contributing risk factor to the development of the fibrous epulis since dry oral mucosa is more susceptible to damage from local irritants (hormonal imbalance and localized periodontitis in this case) when compared to a moist and hydrated surface. However, in the abovementioned case, felodipine could have also contributed to the gingival overgrowth by acting on long-lasting type (L-type) calcium channels that are characterized by a slow rate of inactivation.…”
Section: Case Presentationmentioning
confidence: 99%
“…Furthermore, the clinical manifestations in previously reported cases of GO included erythematous and edematous hyperplastic gingival tissues, numerous food sediments and severe periodontitis (32,33), all of which were accompanied by poor oral hygiene (34). Therefore, it may be reasoned that the poor gingival hygienic conditions of the present case served as another contributing factor to DIGO (35). However, how these contributing factors act synergistically remains elusive.…”
Section: Discussionmentioning
confidence: 85%
“…Previously, Fay et al (4) and Khzam et al (35) suggested that surgery and application of antibiotics should be considered as the second choice for treating DIGO. Indeed, upon revision of the medication strategy for the present case, i.e., replacement of the CCB with a diuretic, the symptoms of gingival soreness were relieved and GO had been partially eliminated within 3 months.…”
Section: Discussionmentioning
confidence: 99%